| NPI | 1285983197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID ROSEBOROUGH Owner 510-452-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A92548) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: CA A92548) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2013-06-11 |